Here are the answers to the most pressing questions from patients and observers about how to navigate Prospect’s bankruptcy.

Prospect’s hospitals remain open, according to company executives and state officials.

“Prospect has communicated that they do not anticipate any interruptions to patient services or care at their Rhode Island facilities as a result of this filing,” said Joseph Wendelken, a spokesperson for the Rhode Island Department of Health.

Right now, state officials and company executives say yes and note that the sale of the two hospitals to Georgia-based nonprofit The Centurion Foundation is still in progress. A deal was approved with “non-negotiable” conditions in June 2024 by Rhode Island Attorney General Peter F. Neronha.

Chief Judge Stacey G. Jernigan of the United States Bankruptcy Court for the Northern District of Texas will oversee the bankruptcy case of Prospect Medical Holdings.US Bankruptcy Court

Now that Prospect has filed for bankruptcy, Texas Chief Judge Stacey G. Jernigan would have to approve the sale. If she does not, “then those hospitals are assets that are in the pool of assets to satisfy creditors,” Neronha said.

“The positive news for Rhode Islanders is that the conversion process for local Prospect-owned hospitals was already well underway, and disruption to the state’s health care system can be minimized,” said US Senator Sheldon Whitehouse, a Rhode Island Democrat.

Staff within the Rhode Island Department of Health are continuing their oversight of the two hospitals, according to Wendelken.

“We monitor in several areas, including looking for any changes in feedback trends from patients or staff, any increases in the cancellation of procedures, and requests for adjustments to a hospital’s diversion approach,” which is an indication of how a facility is managing emergency department volume, Wendelken said on Monday.

Prospect has communicated that it does not anticipate any interruptions to patient services or care at its Rhode Island facilities as a result of this filing.

The state also receives financial statements from the facilities “regularly,” Wendelken said.

Prospect Medical Holdings, a national, for-profit health care chain, owns multiple hospitals in California, Rhode Island, Connecticut, and Pennsylvania. Prospect also owns health facilities in Delaware, Texas, and elsewhere. Prospect’s hospitals in California are not part of the bankruptcy suit.

Prospect was previously controlled by private equity firm Leonard Green & Partners. When it divested its shares in 2021, it sold them to wealthy financiers Sam Lee and David Topper. Topper now serves as the company’s co-CEO, while Lee serves as Prospect’s board chairman.

Prospect owns 16 hospitals in four states.

In Rhode Island, Prospect owns and operates Our Lady of Fatima Hospital in North Providence and Roger Williams Medical Center in Providence. In Connecticut, Prospect owns and operates Waterbury Hospital, Rockville General Hospital, and Manchester Memorial Hospital.

In 2016, Prospect acquired Crozer-Keystone in Pennsylvania. Crozer Health includes four hospitals: Crozer-Chester Medical Center, Taylor Hospital, Delaware County Memorial Hospital, and Springfield Hospital. Prospect closed the operating room at Taylor Hospital in the summer of 2024. Prior to that, Prospect shuttered both Springfield Hospital and Delaware County Memorial Hospital.

In California, Prospect operates several safety-net hospitals; the Los Angeles Community Hospital, Bellflower Behavioral Health Hospital, Foothill Regional Medical Center, Norwalk Community Hospital, Southern California Hospital at Culver City, Southern California Hospital at Hollywood, and the Van Nuys Behavioral Health Hospital.

Prospect also operates a network of 166 outpatient clinics and centers, according to its website.

In Rhode Island, Roger Williams and Fatima Hospital care for the state’s most vulnerable patients. Their patient mix skews toward mostly public payers and those who are uninsured, according to executives.

Both safety-net hospitals in Rhode Island serve many Medicaid recipients and the uninsured. Patients have struggled with dire conditions, including bedbugs, cockroaches, and mice. These issues have put patients in “immediate” jeopardy, according to health department investigators.

Though the emergency room at Roger Williams was renovated in 2019 as part of a $15.1 million project and the building’s exterior looks impressive, during a visit in early 2024, accreditors found brown water flowing from an eye wash device, “black substances” on the walls, improper sterilization, and problems with staff administering anesthesia, court documents show.

“Not only are the hospitals scrambling to obtain supplies day to day, but other areas of the hospital are falling into disrepair,” wrote Superior Court Judge Brian Stern in a June 2024 decision that forced Prospect to pay $17 million in unpaid bills.

As conditions at Roger Williams and Fatima hospitals deteriorated, Prospect’s executives extracted millions of dollars to pay out dividends.

Prospect was controlled by private equity firm Leonard Green & Partners from 2010 to 2021. During that time, Prospect paid out $658 million in dividends and fees. Prospect’s former chief executive Sam Lee, who now acts as the company’s chairman, was paid at least $90 million in 2018 alone.

During US Senator Sheldon Whitehouse’s time as chairman of the US Senate Budget Committee, he co-led an investigation into how certain private equity firms, including Prospect Medical Holdings, are draining the health care system across the United States. Last week, the bipartisan committee released a powerful report with its findings, which the committee said explained “overwhelming evidence of financial mismanagement” as Leonard Green and Prospect Medical sought to drive profits. In doing so, they cut services and entire hospitals that served vulnerable communities.

In a scathing critique, 11 state attorneys general last June called Prospect Medical “possibly the worst example of private equity greed: enriching investors at the expense of low-income, vulnerable patients.”

When Leonard Green & Partners wanted to divest their shares in Prospect, Neronha forced them to place $80 million in an escrow account to “ensure the financial viability” of Roger Williams and Fatima hospitals. More than $30 million of those funds have been used since 2021, according to Neronha.

Neronha’s office is sending attorneys to Texas to advocate for the transaction between Prospect and Centurion to close, which would return the two hospitals to nonprofit status. The Centurion Foundation, according to president Ben Mingle, has not been discouraged by the bankruptcy filing.

“This latest development in no way diminishes our interest or enthusiasm,” Mingle told the Globe in a statement. “We will work closely with all parties, including through the bankruptcy process, to advance the sale as quickly as possible. It is our hope that the court will recognize that after over eighteen months of formal review by the Rhode Island Department of Health and Rhode Island Attorney General, we have achieved full regulatory approval to secure these safety net hospitals, their 2,700 employees, and the critical role they play serving thousands of Rhode Islanders.”

Watch Alexa Gagosz discuss this story on WPRI Channel 12, or in the player above. See more Globe Rhode Island stories that have been featured on Channel 12 here.

Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.